Fears Brexit could delay delivery of vital cancer products

Fears Brexit could delay delivery of vital cancer products

Importation of life-saving isotopes at risk if UK crashes out of EU

British Prime Minister Theresa May with her husband Philip at a church service yesterday.
PHOTO: Steve Parsons/PA Wire

Top-level plans are being drawn up to try to avoid a risk to cancer patients in Irish hospitals in the event of a no-deal Brexit, which could cause a shortage of life-saving products vital to the diagnosis and treatment of the disease.

There is particular concern around the prompt supply of time-critical radioactive isotopes used in 24 hospitals which are essential for diagnostics and treating cancers.

This imported radioactive material is also used in the care of patients with brain conditions, as well as in palliative treatments and cardiovascular scans.

These regulated radioisotopes, which are currently delivered to Irish hospitals, are normally transported from countries such as the Netherlands in lorries through the UK – but they decay quickly and cannot be stockpiled.

A spokeswoman for Ireland’s medicines’ watchdog, the Health Products Regulatory Authority (HPRA), confirmed that a number of suppliers are involved and they have “provided assurances that they have taken appropriate actions, including the review of supply chains to facilitate continuity”.

Industry sources said there was likely to be increasing reliance on air freight to transport medicines but it is more costly and will increase prices. This will also need specialist handlers and airport capacity.

Ensuring the timely transport of some healthcare products with a short shelf-life for Irish patients will remain a concern after an orderly Brexit, although this will allow for changes to be phased in.

Dr Niall Sheehy, a consultant radiologist in St James’s Hospital, said the shelf-life of a radioisotope varies but typically it is a “matter of days”.

He pointed out they are used in medical imaging in general in cancer cases.

“Radioisotopes cannot be stockpiled and they decay. We don’t make any in Ireland and the UK does not either.

“They are typically made in Holland and we would currently get our products via the UK. If the UK left the EU, we would have to find another delivery port.

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“We will have to have our own delivery which will make it more expensive in the long term. In the short term there is also the uncertainty of supply.”

There are lots of different radioisotopes but the commonest are used for cancers of the bone, breast and prostate.

A hospital such as St James’s needs a supply of radioisotopes every day.

“It would be a serious patient risk if we were to stop using them for a long period of time. We could tolerate a few days but the longer without them, the more the risk would be,” said Dr Sheehy.

They are of particular importance in areas such as detecting if a cancer has spread.

Ireland’s access to these products is assured as a member of the EU and it will continue to have the advantage of being a member of Euratom (the European Atomic Energy Community). But timely transport is critical.

These are among a number of products which are regarded as vulnerable post-Brexit and are demanding special attention.

The HPRA said that the “key risk to medicines supply, presented by a disorderly Brexit, is due to potential delays at customs and border controls.

“The HSE and HPRA have advised that the supply of a small number of products may be vulnerable with particular consideration being given to radioisotopes, medicines subject to cold storage, and products that require specialised manufacturing processes.”

Keeping a consistent cold chain is vital for vaccines and insulin for diabetics.

There is also concern around what is known as total parenteral nutrition needed for sick newborns. This is a fluid that gives calories in the form of carbohydrates, proteins, vitamins, mineral and fats. Around 15pc of total parenteral nutrition used in Ireland is imported from the UK.

The HSE and HPRA are contacting suppliers to ensure contingency plans are in place for Brexit.

The HPRA added: “In addition, we are working with the Revenue Commissioners to ensure that any delays at customs are minimised.

“Regardless, our distribution system already holds sufficient stocks to help absorb any short-term delays that may arise.”